Spray nozzle design for a catheter

ABSTRACT

A catheter-based medical device including controlled refrigerant dispersion is disclosed. The device includes a fluid injection tube that carries refrigerant from a coolant supply to the distal portion of the device. A fluid dispersion unit is disposed on the distal end of the fluid tube to control the angle of distribution for refrigerant that is expelled from the fluid injection tube. Controlling the angle of distribution for the refrigerant facilitates dispersion of the fluid in a predetermined spray pattern. The disclosure further relates to cryoablation treatment systems incorporating such a catheter, and to cryoablation treatment methods for tissue treatment to address various conditions suitably treatable with cryoablation.

FIELD

The disclosure relates to catheter-based medical devices, and moreparticularly to mechanisms and methods for controlling the dispersion ofcryogenic fluid from a cryoablation catheter.

BACKGROUND

Many medical procedures are performed using minimally invasive surgicaltechniques wherein one or more devices are inserted through one or moresmall incisions into a patient's body. For example, a cardiac arrhythmiamay be treated through selective ablation of cardiac tissue to eliminatethe source of the arrhythmia. Radio frequency energy, microwave energy,laser energy, extreme heat, or extreme cold may be provided by theablation device to ablate the tissue.

One category of such ablation devices is the minimally-invasive,catheter-based device that is introduced into the vasculature and usedto treat tissue by cooling contact. Such catheter-based devices,henceforth generically referred to herein simply as “catheters” have anelongated body through which a cooling fluid circulates to a tip portionwhich is adapted to contact and cool tissue. The cooling fluid used withsuch catheters may be a low temperature fluid, or cryogens. In general,the catheters may be used to lower the temperature of tissue, such ascardiac wall tissue, to an extent such that signal generation orconduction ceases and allows one to map or confirm that the catheter ispositioned at a particular lesion or arrhythmia conduction site. Morerecently, cryoablation catheters have been configured for ablationtreatment, to cool the tissue to a much lower level at which freezingdestroys the viability of the tissue, and, in the case of cardiactissue, permanently removes it as a signal generating or signalconducting locus. Such devices are also useful for tissue destruction inother contexts, such as the ablation of tumorous, diseased, precancerousor congenitally abnormal tissue.

The catheters may be adapted for endovascular insertion, or forinsertion along relatively confined pathways, for example through a bodylumen, or through a small incision to and around intervening organs, toreach an intended ablation site. As such, they are characterized by arelatively elongated body through which the cooling fluid circulates,and a tip or distal end portion where the cooling is to be applied. Therequirement that the coolant be localized in its activity posesstringent constraints on a working device. For example, when thecatheter contact must chill tissue to below freezing, the coolant itselfmust attain a substantially lower temperature. The rate of cooling islimited by the ability to supply coolant and circulate it through theactive contact region, and the efficacy of the contact region itself isfurther limited by geometry and physical properties that affect itsability to conduct heat into the tissue.

Furthermore, it is generally desirable to control the direction of thecryogenic fluid flow to only the target tissue sites. In someprocedures, a spot tissue ablation procedure—where the fluid flow isdirected at a specific site—may be acceptable. For other procedures, itmay be more therapeutically effective if the fluid flow is directedalong a predetermined line, or a single elongate ring or linear lesioncreated in a single ablative step. However, the small dimensions of thecatheter assembly have the result that flow conditions existing withinthe catheter tip are turbulent and chaotic. This arises in part becausethe high pressure release of fluid in a relatively small chamber at thetip of the catheter and/or its recirculation back via a return conduitfrom the tip region involve relatively turbulent fluid flow conditions,so that the precise control of directional contact on the tissue may besubject to rather wide variations. Thus, while conventional catheterarrangements have been found to provide a high level of cooling, theintroduction at high pressure into the small expansion chamber resultsin cavitation, turbulence and irregular fluid flow evolving in the shortdistance and brief time between the jet spray of expanding coolant andthe lower pressure conditions existing at the proximal end of thechamber adjacent the coolant return passage.

Accordingly, cryoablation catheters could benefit from improvedtechniques and devices for providing uniform and evenly controlled flowof the thermal transfer fluid onto the targeted tissue cells.

SUMMARY

The disclosure generally describes a cryoablation catheter for use intissue ablation. The catheter comprises an elongate supply lumen, orinjection tube, which carries a cryofluid or refrigerant from arefrigerant supply unit. Typically, a source of refrigerant is connectedto the proximal end of the supply lumen and a cryochamber, or expandablechamber, is located at the lumen's distal end. In some embodiments, thesource of refrigerant is a fluid that is ejected from the supply lumenthrough an orifice coupled at a distal portion of the lumen and housedwithin the expandable chamber. The catheter also comprises a fluiddispersion unit that is also housed, at least partially, within theexpandable chamber. At the predetermined pressures to which thecryoablation fluid is subjected, the construction of the fluiddispersion unit must be so designed and dimensioned to disperse adefinite amount of fluid within certain limits. The dispersion unit ofthe present disclosure serves to evenly distribute the refrigerantexiting the distal end of the supply lumen across at least some portionof the interior of the expansion chamber.

Accordingly, embodiments of the disclosure teach fluid dispersion unitswhich control the distribution of fluid flowing therethrough. In oneexample, the fluid dispersion unit comprises a flow distribution sleevethat induces in a fluid expelled from there sleeve a motion having apredetermined pattern. In another example, the fluid dispersion unitcomprises a deflection member that redirects the direction of flow of afluid in a predetermined pattern. In yet another example, the fluiddispersion unit comprises an arrangement of the flow distribution sleeveand the deflection member.

In accordance with an embodiment of the disclosure, a fluid nozzle isdisposed on the distal end of a supply lumen. The fluid nozzle isdisposed within a fluid dispersion unit in a predetermined arrangement.In some examples, the arrangement of the fluid nozzle and the fluiddispersion unit causes fluid flowing from the nozzle to undergo apredetermined motion.

Other embodiments disclose a catheter which includes an outer tubularmember capable of insertion into the vessels of the body. An expandablechamber, such as a distendable balloon, is disposed at the distal end ofthe outer tubular member. An inner tubular member substantially spanningthe length of the outer tubular member may be employed to carry a fluidto the interior of the expandable chamber. A fluid nozzle is disposed onthe distal end of the inner tubular member. A fluid dispersion unit isprovided in fluidic-communication with the fluid dispersion unit forcontrolling the direction of dispersion of the fluid.

BRIEF DESCRIPTION OF THE DRAWINGS

The following drawings are illustrative of particular embodiments of thepresent disclosure and therefore do not limit the scope of thedisclosure. The drawings (not to scale) are intended for use inconjunction with the explanations in the following detailed description,wherein similar elements are designated by identical reference numerals.Moreover, the specific location of the various features is merelyexemplary unless noted otherwise.

FIG. 1 illustrates an exemplary ablation catheter of the presentdisclosure as it would be deployed and used for an ablation procedure.

FIG. 2 shows a cryogenic treatment system in accordance with anembodiment of the disclosure.

FIG. 3 depicts a longitudinal cross-sectional view of an exemplarycatheter tip in accordance with an embodiment of the present disclosureis illustrated.

FIG. 4 illustrates an exemplary embodiment of a catheter constructed inaccordance with principles of this disclosure.

FIG. 5 illustrates an embodiment of a catheter tip constructed inaccordance with principles of this disclosure.

FIGS. 6-8 illustrate alternative embodiments of a catheter in accordancewith the present disclosure.

DETAILED DESCRIPTION

It is to be understood that both the foregoing general description andthe following detailed description are exemplary and explanatory onlyand are not restrictive of the disclosure. The accompanying drawings,which are incorporated in and constitute a part of this specification,illustrate several embodiments of the disclosure and together with thedescription, serve to explain the principles of the disclosure.

In one aspect, the catheter described herein can be used for performingablation near or within the pulmonary veins of the heart where anablation band that may have a circumferential or linear geometry acrossthe targeted tissue is formed. However, the devices described herein arenot limited to cardiac applications.

To better understand the environment in which the devices and methods ofthe present disclosure are used, a general overview of an ablationprocedure is believed to be useful. The example pertains to acatheter-based ablation treatment of cardiac arrhythmias, wherein aspecific area of cardiac tissue having aberrant conductive pathways,such as atrial rotors, emitting or conducting erratic electricalimpulses, is cold-treated through energy transfer derived fromthermodynamic changes occurring in the flow of a cryogenic fluid throughthe catheter device. This energy transfer creates a net transfer of heatfrom the target tissue to the device, typically achieved by cooling aportion of the device to very low temperature through conductive andconvective heat transfer between the cryogen and target tissue.

Referring to FIG. 1, the treatment to be accomplished with the devices,systems and methods described in this disclosure is illustrated. FIG. 1shows a cutaway view of the human heart 10, showing the major structuresof the heart 10 including the left and right atria, and the pulmonaryveins 15 a, 15 b. The atrial septum separates the left and right atria.The fossa ovalis 11 is a small depression in the atrial septum that maybe used as an access pathway to the left atrium from the right atrium,such as with a transeptal puncture device and transeptal sheath. Thefossa ovalis 11 can be punctured, and easily reseals and heals afterprocedure completion. In a patient suffering from atrial fibrillation,aberrant electrically conducive tissue may be found in the atrial walls,as well as in the pulmonary veins 15 a, 15 b. Ablation of these areas,referred to as arrhythmogenic foci (also referred to as drivers orrotors), is an effective treatment for atrial fibrillation. Systems,devices and methods of the present disclosure provide means of creatinglesions, including lesions to surround the pulmonary vein ostia, and aredeployed to identify and ablate the driver and rotor tissue.

To accomplish this, a catheter (FIG. 2) is inserted into the rightatrium, preferably through the inferior vena cava or through thesuperior vena cava. The catheter is sized for advancement through thepatient's vasculature. As an example, which is not intended to belimiting, an exemplary catheter may have a shaft having a diameterranging from 7-9 Fr, with the shaft length ranging from 100-125 cm andthe overall length being in the range of 140-160 cm. The catheter may bepassed through transeptal sheath, which may or may not be a deflectablesheath since the catheter preferably includes a deflectable distalportion. When passing into the left atrium, the transeptal sheath passesthrough or penetrates the fossa ovalis 11, such as over guide wire 17which may have been placed by the transeptal puncture device. Thecatheter is inserted over guide wire 17 and through transeptal sheathsuch that its distal end enters the lumen of right superior pulmonaryvein 15 a, 15 b. The catheter carries an ablating element, such as anexpandable chamber (FIG. 2) into the left atrium. The expandable chamberis transitioned to expand to a maximal diameter by, for exampleinflation, such that the expandable chamber is in contact with the wallsof the target tissue e.g., pulmonary vein ostia to occlude the vein.

An electrical mapping procedure may be performed to identify or confirmthe location of the target cardiac tissue. Next, a treatment medium(e.g., cryogenic fluid) provided by a source external to the patient, isprovided through the catheter into the ablating element to ablate theneighboring tissue and form a lesion. The system may utilize varioussystems, such as the Joule-Thompson effect, to achieve the coolingincluding the exemplary systems described in commonly-assigned U.S. Pat.No. 7,780,657 to Abboud et al., entitled “COOLING SYSTEM,” which issuedon Aug. 24, 2010, and is incorporated herein by reference in itsentirety. For example, in one embodiment, a pressurized liquid or aliquid/gas mixture passes into a region where it is enabled toevaporate. In other embodiments, a cryogenic fluid delivered to anexpandable balloon is a pressurized gas wherein expansion of thepressurized fluid effects the cooling. Accordingly, the cooling methodsmay allow for expansion of a compressed fluid independent of whetherthere is a phase change and/or may include phase changes from liquid togas or an expanded gas being cooled to such an extent that a portion ofthe expanded gas actually condenses into a liquid phase. Suitablecryogenic fluids will be non-toxic and include nitrogen, nitrous oxide,carbon dioxide, and the like. By delivering the cryogenic fluid throughthe catheter body, the balloon can be expanded and cooled in order toeffect treatments according to the present disclosure.

The created lesions may be segmented and localized. The lesions may belinear or curvilinear, circumferential and partial circumferential,and/or continuous or discontinuous. The lesions created by the ablationcatheters are suitable for inhibiting the propagation of inappropriateelectrical impulses in the heart 10 for prevention of reentrantarrhythmias. In general, the catheter ablation therapy will disrupt theelectrical pathways in cardiac tissue to stop the emission of and/orprevent the propagation of erratic electric impulses.

FIG. 2 shows a cryogenic treatment system 20 in accordance with anembodiment of the disclosure. System 20 includes a treatment catheter 22having a handle 24, and elongated cryogen transporting body 26 and acatheter tip 28 (described in more detail in FIG. 3). The catheter 22 isconnected by various conduits or cables to a console 30 which may, forexample, have a display monitor 32 and other data entry or displayaccessories such as a keyboard, a printer and the like. Operation of theconsole 30 involves controlling the timing and amount of coolantinjected through the catheter 22 at a defined injection pressure, whichmay be a pressure of about 400 psig, for example. The entire catheter 22may be dimensioned to fit in a No. 14 French introducer or smaller. Theconsole 32 is connected to the catheter 22 by various lines 34 which mayinclude a coolant injection line 36, a coolant return line 38 andelectrical cabling 40 which carries outputs of various cardiac sensing,thermal sensing, mapping or other elements as may be used for cathetertreatment or monitoring. As shown, the handle 24 is equipped with inputports for an electrical connector 42, a coolant injection tube connector44, and a return tube connector 46. These connect by various internaljunctions or tubes passing through the handle and elongated body 26 tothe distal tip of the catheter. The handle 24 may also include variouscontrol assemblies, e.g., switches or valves, as well as safetydetection or shutdown elements (not illustrated).

Turning to FIG. 3, a longitudinal cross-sectional view of an exemplarycatheter tip in accordance with an embodiment of the present disclosureis illustrated. Tip 28 of the exemplary catheter 22 comprises an outertube 50 which may be coupled to an outer balloon 52. An inner balloon 54may be disposed within the outer balloon 52. The void within innerballoon 54 defines an expandable chamber 56. In use, both the outerballoon 52 and inner balloon 54 may be expanded concurrently to contacta blood vessel or other tissue during an ablation procedure. Althoughthe exemplary embodiment depicts a gap between portions of the outerballoon 52 and inner balloon 54, it should be noted that the entireperimeter of both outer balloon 52 and inner balloon 54 may be incontact. The outer balloon 52 contains leaks in the inner balloon 54should they occur. Low pressure or vacuum return lumens 58 and 58′ maybe in fluid communication with the interior of the outer and innerballoons, respectively.

Outer tube 50 defines a lumen that may circumferentially enclose aninjection tube 60 so that the tubes may be substantially coaxiallydisposed with respect to each other, such that a longitudinal centerline(not shown) of outer tuber 50 approximately coincides with thelongitudinal centerline (not shown) of injection tube 60. Injection tube60 may substantially span the length of outer tube 50 and may terminateat a point slightly more distal to the absolute distal end of outer tube50 such as within the second balloon 60. Injection tube 60 willgenerally be in fluid communication with the coolant injection line 36(FIG. 2) while the return lumens 58 and 58′ will typically be in fluidcommunication with coolant return line 38 (FIG. 2). However, otherimplementations in accordance with the principles set forth herein arecontemplated. For example, while the injection tube 60 in fluidcommunication with injection line 36 have been illustrated as beingseparate components, other exemplary embodiments may combine bothcomponents into a unitary component.

Injection tube 60 may be disposed over a guidewire structure such as atube, a shim or the guide wire 17 that passes through or is containedwithin the lumen defined by outer tube 50. The guide wire 17 is suitablefor placement into the vasculature of a patient and catheter may slideover the guide wire, for guiding the distal tip 28 of the catheter 22 toa desired location using techniques known in the art. In someembodiments, the distal tip 28 can include a soft tip element 62 tominimize or prevent tissue trauma.

A fluid dispersion unit 110 (described in more detail in conjunctionwith the representative embodiments of FIGS. 4-6) may be coupled to thedistal portion of injection tube 20. In general, fluid dispersion unit110 defines a chamber in which a fluid is introduced at a selected flowrate and from which the fluid is ejected in a predefined distributionpattern. Among other things, the pattern takes into account the sprayangle and distribution of the fluid across a cross section of the spray.The distribution pattern will be dependent principally on the shape ofthe fluid dispersion unit 110. The fluid dispersion unit 110 generallydirects and/or the dispersion of fluid flowing from the injection tube60 into the expandable chamber 56 and onto an interior surface of theinner balloon 54. As such, the fluid dispersion unit 110 provides anexit point for the cryogen flowing through the injection tube 60 intothe expandable chamber 56.

A compression spring 100 is further illustrated being coupled to thefluid dispersion unit 110. Any suitable material that will exhibit thedesired elastic properties including, for example, stainless steel maybe employed in the construction of the spring. The compression spring100 may have a preset length that is determined by such factors as thedesired location within the expandable chamber wherein the fluid contactis desired. However, in other implementations, the compression spring100 may be moveable in an axial direction, such as through actuationwith the guide wire or some other physical implement, an electricallyactivated actuator, fluid pressure variation, or through any othersuitable means. The compression spring 100 may be selectively moveableto vary the location of the fluid dispersion unit 110. Some factors thatmay be taken into consideration when selecting the location of the fluiddispersion unit 110 will include the spray diameter and the desiredcontact location within inner balloon 54.

FIG. 4 illustrates an exemplary embodiment of a catheter constructed inaccordance with principles of this disclosure. The depiction shows animplementation where the injection tube 60 is coupled to a refrigerantcoil 120. A proximal portion 124 of the refrigerant coil 120 is coupledto the distal end of the injection tube 60 to provide a continuous lumenfor flow of a fluid therein. The refrigerant coil 120 terminates with acoil outlet or flow nozzle 126 at a terminal distal portion 122. Thedistal portion 122 of the refrigerant coil 120 may be shaped to inducein a fluid passing therethrough a predetermined motion. For example, thedistal portion 122 may be coiled or wound in a helical, spiral,curvilinear, or coiling configurations to induce a correspondinglyshaped motion for example. In some embodiment, the coil pitch may alsobe varied to achieve the desired fluid motion.

In other embodiments, inducing a selected shaped motion is achieved bythe interaction of fluid flowing from portion 122 with the fluiddispersion unit 110. This may be through, for example, disposing the tipof portion 122 terminating at the flow nozzle 126 within fluiddispersion unit 110 such that the fluid will flow tangentially to thelongitudinal axis of fluid dispersion unit 110. For example, at leastthe distal tip of portion 122 may be aligned in an orthogonal axis inrelation to the longitudinal axis of the fluid dispersion unit 110 toinduce a swirling motion in the fluid exiting from the fluid nozzle 126within the fluid dispersion unit 110.

Continuing with the depiction of FIG. 4, fluid dispersion unit 110 a isformed as a tubular-shaped sleeve that encloses the distal portion 122of refrigerant coil 120 in a catheter tip 28 a. The exemplary sleeve ofunit 110 a may be formed from a material such as stainless steel orpolyimide. A proximal end 112 of fluid dispersion unit 110 a may besealed to prevent the expulsion of a fluid medium through the proximalend 112, in one example. In some examples, a portion (or the entire)interior surface of the sleeve may be coated with a hydrophobicmaterial. The hydrophobic material will facilitate the repulsion of thefluid medium flowing through the fluid dispersion unit 110 a and therebyreduce the capillary effect associated with fluid agglomeration such asat the distal tip of the fluid dispersion unit 110 a.

With that in mind, a high pressure, low temperature fluid is typicallysupplied to the catheter 22, and initially enters the catheter 22 as itflows through the injection tube 60 towards the expandable chamber 56.Conventional injection tubes generally have one or more orifices fromwhich the fluid will flow. However, the location at which the fluidcontacts inner balloon 54 as it is ejected from the orifice will varydepending on the orientation of the injection tube 60, the size to whichthe balloons have been expanded, and even the orientation, size andlocation of the orifice.

In the present embodiment, the fluid will upon flowing through theinjection tube 60, exit the injection tube 60 through the outlet 126.The fluid being expelled from outlet 126 will come in contact with theinterior surface of fluid dispersion unit 110 a at an angle that isdependent on the orientation of the distal tip of portion 122. Forinstance, outlet 126 may be configured to direct the flow of fluid intothe fluid dispersion unit 110 a in an angle that is tangential to thelongitudinal axis of the fluid dispersion unit 110 a (depicted as angleα in FIGS. 4-8). As such, the fluid exiting outlet 126 will be caused tospin in a predetermined motion with the motion being dependent on theshape of the fluid dispersion unit 110 a. The spin velocity of the fluidwill increase as the fluid approaches the distal tip of the fluiddispersion unit 110 a. However, all of the pressure of the fluidsupplied by the injection tube 60 is not all converted into velocityenergy. Some of the energy is maintained as pressure energy which willtend to push the fluid distally toward the distal tip of fluiddispersion unit 110 a. This pressure urges the fluid to attain apredetermined spray pattern because of the centrifugal force. As such,the fluid is ejected at the distal end of unit 110 a into the expandablechamber 56 in the predetermined spray pattern 130. In other words, asthe fluid spins toward the distal end of the fluid dispersion unit 110a, the centrifugal force exerted on the fluid as it rotates throughfluid dispersion unit 110 a will result in the fluid being dispersedfrom the fluid dispersion unit 110 a in a motion that will cover a 360degree angle. After flowing into the expandable chamber 56, the fluid isinduced, through a negative pressure gradient, to flow back towards theproximate portion of the catheter 22 through the return lumen 58′.

The length and diameter of the fluid dispersion unit 110 a may beselected during construction to control the angle of dispersion of fluidfrom the distal end. In addition, the location of the outlet 126 withinfluid dispersion unit 110 a may also be varied to control the angle ofdispersion and conversely the fluid dispersion unit 110 a may bemoveable with the expandable chamber 56 to vary the angle of dispersion.It should be noted that the angle of dispersion of fluid from fluiddispersion unit 110 a directs the fluid in a desired direction and hencecontrols the location of contact of the fluid with inner balloon 54.Therefore, the location of the fluid dispersion unit 110 a withinexpandable chamber 56 may also be varied as previously described withthe compression spring 100 to channel the fluid to a desired location.As illustrated schematically by the arrows, the spray pattern 130 in theexpandable chamber will generally cause the fluid to come in contactwith a preselected portion of the inner balloon 54. As such, in ablationprocedures, adjustment of the angle of dispersion of fluid from fluiddispersion unit 110 a adjusts the angle of fluid dispersion, and hencethe location of contact, to target the ablation zone.

Additionally, because the angle of the fluid that is ejected from thefluid dispersion unit 110 a depends mainly on the velocity vector of thefluid (axial speed as opposed to radial speed), the angle of the distalportion 122 leading to outlet 126 can be varied to provide a differentangle of distribution of fluid being dispersed from the distal end offluid dispersion unit 110 a.

The fluid dispersion unit 110 may be embodied in other shapes configuredto direct the flow of coolant in a predetermined direction and/orpattern.

FIG. 5 illustrates an alternative embodiment of the catheter 22.Specifically, a catheter tip 28 b is depicted with a fluid dispersionunit 110 b having a conical shape. The desired shape will be selectedsuch that a desired flow pattern is induced in the fluid exiting theoutlet 126 and contacting the inner surface of the fluid dispersionunit. The fluid, thereby predisposed to have a given pattern, will beexpelled from the fluid dispersion unit 110 b to preselected locationson the inner balloon 54.

FIG. 6 illustrates another exemplary embodiment of the catheter 22. Inthe embodiment, a catheter tip 28 c includes a fluid dispersion unit 110c having an inverted conical shape wherein the diameter of the proximalend is larger than the diameter of the distal end.

FIG. 7 illustrates an alternative embodiment of the catheter 22 inaccordance with the present disclosure. In accordance with other aspectsof the disclosure, it is contemplated that a fluid dispersion unit suchas the aforementioned fluid dispersion unit 110 a, fluid dispersion unit110 b, or fluid dispersion unit 110 c (collectively “fluid dispersionunit 110”) may be alternatively employed in this embodiment. A cathetertip 28 d includes fluid dispersion unit 110 that cooperates with adeflector member 210 both of which are disposed within the expandablechamber 56. The deflector member 210 is positioned at a suitabledistance distal of the dispersion unit 110 to condition flow of thefluid leaving dispersion unit 110. As depicted in the illustrativeembodiment of FIG. 7, deflector member 210 is embodied as a guide flangehaving an inclined plane with the inclined surface channeling the flowof fluid expelled from the dispersion unit 110 along a defined path. Thelength and incline of deflector member 210 may be configured to extendalong an axial direction so as to channel the fluid to specificlocations along the inner circumference of the inner balloon 54 whilepreventing dripping onto undesired portions of the inner balloon 54. Assuch, the deflector member 110 b may enhance the control of the flowdirectionality of a fluid ejected from the fluid dispersion unit 110.

FIG. 8 depicts yet another alternative embodiment of the catheter inaccordance with the present disclosure. In the illustration, a cathetertip 28 e includes fluid dispersion unit 110 that cooperates withdeflector member 210 as described with reference to FIG. 7. Thedeflector member 210 is further coupled to compression spring 100. Thecompression spring is moveable along an axial direction to influence thelocation of the deflector member 210 within the expandable chamber 58.For example, the pressure of the cryogen fluid expelled from therefrigerant coil 120 may be selectively-adjusted so as to causeextension/contraction of the spring 100 to a desired length. Thecontraction/expansion of the spring 100 also causes a reciprocalmovement of the deflector member 210 and thereby regulates the positionof the deflector member 210 within the expandable chamber 58. Othersuitable mechanisms for compression/expansion of the compression spring100 such as those described in conjunction with FIG. 3 may alternativelybe employed.

It should be noted that a wide variety of spray patterns and sprayangles may be achieved by any one of the various exemplary fluiddispersion units disclosed herein. Thus, for any given implementation,such factors as the distance between the distal tip of fluid dispersionunit 110 to the desired fluid contact location on inner balloon 54, thecircumference of the fluid dispersion unit 110, the length of the fluiddispersion unit 110, the flow rate of fluid flowing from the injectiontube 60, or the pressure of fluid flowing from the injection tube 60 canall be varied. For example, a hollow cone spray pattern in which thefluid concentration is at the outer edge of the cone with little or nofluid in the center may be generated by the tubular fluid dispersionunit 110 in which a cylindrical chamber causes the fluid to spin andachieve the hollow cone pattern. The spray angle and hence the diameterof the contact points between the expelled fluid and the inner balloon54 can be varied by adjusting the various aforementioned factors such ascoil angle and coil pitch.

The preceding specific embodiments are illustrative of the practice ofthe aspects of the disclosure. Various modifications can be made withoutdeparting from the scope of the claims. For example, in embodimentswhere a refrigerant coil 120 is not utilized, the distal portion ofinjection tube 60 may suitably be shaped as described with respect tothe distal portion 122 of refrigerant coil 120 to induce similar motionsin a fluid exiting through a nozzle of the tube 60. The similarly shapeddistal portion of the injection tube 60 may then be enclosed within thefluid dispersion unit 110 to facilitate fluid expulsion as describedabove. Various examples for controlling the dispersion of fluid from acatheter have been described. These and other examples are within thescope of the disclosure defined by the following claims.

What is claimed is:
 1. A cryoablation catheter comprising: a flexibleouter tubular member; an expandable chamber defining a proximal endcoupled to the flexible outer tubular member; an injection tubularmember substantially spanning the length of the flexible outer tubularmember and in fluid communication with an interior of the expandablechamber, said injection tubular member having a proximal end adapted tobe coupled to a source of cryoablation fluid and a distal end within theexpandable chamber; a fluid nozzle located in a distalmost end face ofthe distal end of the injection tubular member; and a fluid dispersionunit coupled to the distal end of the injection tubular member andhaving a longitudinal axis, the distal end of the injection tubularmember being coiled about the longitudinal axis, the fluid nozzle beinglocated within the fluid dispersion unit and being configured to directa uniform flow of fluid into the fluid dispersion unit in a directionthat is tangential to the longitudinal axis of the fluid dispersionunit, the fluid dispersion unit having an opening at the distalmost endface and being configured to direct a flow path of the uniform flow offluid expelled by the fluid nozzle in a predetermined pattern within thefluid dispersion unit and into an interior surface of the expandablechamber from the opening at the distalmost end face.
 2. The cryoablationcatheter of claim 1, wherein the expandable chamber comprises an innerballoon disposed within an outer balloon and the pattern of the fluidflow contacts an interior surface of the inner balloon.
 3. Thecryoablation catheter of claim 1, wherein the predetermined pattern ofthe flow of fluid within the expandable chamber is selected from a groupconsisting of a circular pattern and an arcuate pattern.
 4. Thecryoablation catheter of claim 1, wherein the fluid dispersion unitcomprises a flow distribution sleeve having a distal end that at leastpartially extends past a distal tip of the fluid nozzle.
 5. Thecryoablation catheter of claim 4, wherein an interior surface of theflow distribution sleeve is coated with a hydrophobic material.
 6. Thecryoablation catheter of claim 4, wherein the flow distribution sleeveis tubular shaped.
 7. The cryoablation catheter of claim 4, wherein theflow distribution sleeve is shaped to induce in the cryoablation fluidexiting through the distal end of the fluid nozzle a 360 degree patternwithin the expandable chamber.
 8. The cryoablation catheter of claim 4,wherein the flow distribution sleeve is shaped to induce in thecryoablation fluid exiting through the distal end an arcuate pattern. 9.The cryoablation catheter of claim 1, wherein the fluid nozzle isoriented to induce in a fluid passing therethrough a motion selectedfrom a group consisting of circular motion and a swirling motion. 10.The cryoablation catheter of claim 1, wherein the fluid nozzle takes theform of a Joule-Thompson fluid expansion nozzle.
 11. The cryoablationcatheter of claim 1, wherein the proximal end of said injection tubularmember is coupled to a source of cooling gas.
 12. The cryoablationcatheter of claim 1, wherein the proximal end of said injection tubularmember is coupled to a source of a pressurized liquid.
 13. Thecryoablation catheter of claim 1, wherein the fluid dispersion unitcomprises: a flow distribution sleeve having a distal end that at leastpartially extends past a distal tip of the fluid nozzle; and adeflection member disposed within the expandable chamber and distal tothe distal end of the flow distribution sleeve.
 14. The cryoablationcatheter of claim 13, wherein the fluid dispersion unit is arranged toinduce in the cryoablation fluid exiting through the distal end of thefluid nozzle a 360 degree pattern within the expandable chamber.
 15. Acryoablation catheter comprising: a flexible outer tubular member; anexpandable chamber defining a proximal end coupled to the flexible outertubular member; an injection tubular member substantially spanning thelength of the flexible outer tubular member and in fluid communicationwith an interior of the expandable chamber, said injection tubularmember having a proximal end adapted to be coupled to a source ofcryoablation fluid and a distal end, at least a portion of the distalend having a coiled configuration; a fluid nozzle located in adistalmost end face of the distal end of the injection tubular member; adispersion unit coupled to the distal end of the injection tubularmember and defining a longitudinal axis and being located within theexpandable chamber, the dispersion unit defining a chamber therein andan opening at a distalmost end face, the fluid nozzle being locatedwithin the chamber of the dispersion unit and the fluid nozzle beingoriented at an angle that is tangential to the longitudinal axis andconfigured to direct the flow of fluid into the dispersion unit in auniform direction of rotation within the dispersion unit and to causethe fluid to exit the opening at the distalmost end face of thedispersion unit about an approximately 360° angle; and a deflectionmember disposed within the expandable chamber and being coupled to theinjection tubular member at a location that is distal to the opening atthe distalmost end face of the dispersion unit, said deflection memberbeing configured to control the direction of flow of the fluid exitingthe dispersion unit.
 16. The cryoablation catheter of claim 15, whereinthe deflection member is selectively moveable along a longitudinal axisof the outer injection tubular member and within the expandable chamber.17. The cryoablation catheter of claim 16, wherein the deflection memberis selectively rotatable within the expandable chamber.